| NPI | 1396053641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10001317A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 385.002616) |
| 363AM0700X Physician Assistant Medical (Licence: IN 10001317A) | |
| Enumeration Date | 2010-09-21 |
| Last Update Date | 2021-03-15 |